Provider Demographics
NPI:1447850912
Name:EDISONHEALTH LLC
Entity type:Organization
Organization Name:EDISONHEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:WATSON
Authorized Official - Last Name:CROOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-582-8875
Mailing Address - Street 1:2021 RICHARD JONES RD STE 350B
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2871
Mailing Address - Country:US
Mailing Address - Phone:615-582-8875
Mailing Address - Fax:833-453-1596
Practice Address - Street 1:2021 RICHARD JONES RD STE 350B
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2871
Practice Address - Country:US
Practice Address - Phone:615-582-8875
Practice Address - Fax:833-453-1596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty